P.C. and U.S. Postal Service, Jenks Post Office (Board decision, March 3, 2025)

ECAB final decision. The Board affirmed OWCP’s denial of the claimed back and hip conditions after a postal carrier’s fall. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

A rural carrier fell while delivering a package and sought compensation for lumbar and left hip conditions. The Board accepted that the fall occurred but found the medical record did not connect the diagnosed conditions to it. It gave greater weight to a second-opinion physician who explained the preexisting lumbar disease and lack of objective worsening. The carrier’s physician did not adequately explain how the fall caused or aggravated the conditions, so the Board affirmed the denial.

Decision snapshot

• Authority: FECA; 5 U.S.C. § 8101.
• Outcome: Denial of the claimed lumbar and left hip conditions affirmed.
• Key point: The accepted fall alone did not establish medical causation for the diagnosed conditions.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
P.C., Appellant
)
)
and ) Docket No. 25-0249
)
Issued: March 3, 2025
U.S. POSTAL SERVICE, JENKS POST
)
OFFICE, Jenks, OK, Employer
)
__________ )

Appearances: Case Submitted on the Record
Alan J. Shapiro, Esq., for the appellant1
Office of Solicitor, for the Director

DECISION AND ORDER

Before:
ALEC J. KOROMILAS, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge JANICE B. ASKIN, Judge

JURISDICTION

On January 27, 2025 appellant, through counsel, filed a timely appeal from a January 3, 2025 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.

1
In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 2 5 U.S.C. § 8101 et seq.
ISSUE

The issue is whether appellant has met her burden of proof to establish a medical condition causally related to the accepted September 13, 2018 employment incident.

FACTUAL HISTORY

This case has previously been before the Board. 3 The facts and circumstances of the case as set forth in the Board’s prior decisions are incorporated herein by reference. The relevant facts are as follows.

On September 18, 2018, appellant, then a 56-year-old rural carrier, filed a traumatic injury claim (Form CA-1) alleging that, on September 13, 2018, she sustained abrasions/scratches to her right knee when she lost her footing and fell to the ground while delivering a package in the performance of duty. She indicated that her left side hip and back began to hurt following the fall. On the reverse side of the claim form, the employing establishment controverted appellant’s claim, noting that she had complained of hip and back pain in the past and there was no evidence that the fall actually occurred. Appellant did not stop work. 4

In a September 18, 2018 report, Dr. Mark Stephen Wilson, a specialist in pain medicine, recounted appellant’s history of injury and diagnosed acute traumatic injury resulting in lumbosacral disc displacement with radiculopathy. He opined that her condition was causally related to the accepted employment incident. OWCP continued to receive progress reports from Dr. Wilson.

By decision dated November 27, 2018, OWCP denied appellant’s traumatic injury claim, finding that, while the September 13, 2018 employment incident occurred as alleged, the medical evidence of record was insufficient to establish that her diagnosed condition was causally related to the accepted employment incident.

On January 31, 2019, appellant requested reconsideration and submitted additional evidence.

In a narrative statement dated January 25, 2019, appellant clarified that she initially fell on her right side before injuring her left knee. She asserted that any preexisting conditions that she had were attributable to injuries she had sustained while at work.

3
Docket No. 20-0855 (issued November 23, 2020); Docket No. 22-0428 (issued July 22, 2022).
4
OWCP assigned the present claim OWCP File No. xxxxxx242. Appellant has a prior claim before OWCP. On August 24, 2015, appellant filed a notice of traumatic injury (Form CA-1) alleging that she injured her left shoulder while pushing trays of mail in the performance of duty. OWCP assigned this claim File No. xxxxxx311. On September 15, 2019, it accepted the claim for left rotator cuff sprain, strain of the muscles and tendons of the rotator cuff, left shoulder osteochondritis, bursitis, synovitis and tenosynovitis, and sprain of the shoulder and upper arm. Appellant’s claims have not been administratively combined.

2
By decision dated April 29, 2019, OWCP denied modification of the November 27, 2018 decision.

On October 28, 2019, appellant, through counsel, requested reconsideration and submitted additional evidence.

By decision dated January 24, 2020, OWCP denied modification of the April 29, 2019 decision.

On March 9, 2020, appellant, through counsel, appealed to the Board. By decision dated November 23, 2020, the Board affirmed OWCP’s January 24, 2020 decision, finding that appellant had not met her burden of proof to establish a medical condition causally related to the accepted September 13, 2018 employment incident. 5

OWCP subsequently received a report dated September 8, 2020, from Dr. Nicholas Keith Thompson, an osteopath Board-certified in family medicine and sports medicine. Dr. Thompson noted that appellant had experienced left hip pain since September 13, 2018 when she fell while delivering a package. He indicated that he had reviewed a previous x-ray of appellant’s left hip, and that while appellant did have some mild arthritic change in the left hip, the majority of her symptoms seemed to be related to lumbar radiculopathy. Dr. Thompson diagnosed lumbar radiculopathy, lumbar degenerative disc disease, and left hip osteoarthritis.

OWCP also received supplemental reports from Dr. Wilson. In a report dated February 9, 2021, Dr. Wilson noted appellant’s history regarding her alleged September 13, 2018 employment injury. He reviewed her diagnostic studies and examination findings, and thereafter diagnosed lumbosacral intervertebral disc disorders with L3-4, L4-5, and L5-S1 radiculopathy, lumbosacral radiculopathy, and L4 on L5 spondylolisthesis, which he attributed to her September 13, 2018 slip and fall accident. Dr. Wilson explained that slip and falls, such as the fall down two steps experienced by appellant, was known to be a common cause of spinal injuries. He further explained that the impact from such a fall causes intervertebral discs to become compressed, damaged, or slip out of place. According to Dr. Wilson, the actual event, forces involved, and impact, determine the actual seriousness of an injury.

Dr. Wilson, in a June 15, 2021 report, repeated appellant’s lumbar diagnoses and also diagnosed left hip bursitis, chondromalacia, and muscle, fascia, tendon injury. He reiterated his opinion regarding the cause of appellant’s lumbosacral injury. Dr. Wilson further added that appellant sustained an injury to her hip based on her magnetic resonance imaging (MRI) scan, which demonstrated tearing and injury of the muscle, fascia, and tendon.

On August 11, 2021, appellant, through counsel, requested reconsideration, arguing that Dr. Wilson’s reports had established causal relationship between the diagnosed conditions and the accepted employment incident.

By decision dated January 4, 2022, OWCP denied modification.

5
Id.

3
On January 28, 2022, appellant, through counsel, appealed to the Board. By decision dated July 22, 2022, the Board set aside the January 4, 2022 OWCP decision and remanded the case for further development of the medical evidence.6 The Board found that while Dr. Wilson’s reports were insufficient to meet appellant’s burden of proof to establish her claim, they were sufficient to require OWCP to further develop the medical evidence.

On September 1, 2022, OWCP referred appellant, together with a statement of accepted facts (SOAF), a series of questions, and medical record, to Dr. Timothy G. Pettingell, a Board- certified physiatrist, for a second opinion evaluation regarding whether appellant sustained a medical condition causally related to the accepted September 13, 2018 employment incident.

In an August 17, 2022 report, Dr. Wilson summarized appellant’s medical evidence, provided examination findings, and reiterated his diagnoses of her lumbar and left hip conditions. He also reiterated his opinion regarding the cause of her conditions.

In a report dated October 17, 2022, Dr. Pettingell recounted the history of injury, provided examination findings, and reviewed the medical evidence of record including diagnostic test reports. He diagnosed symptomatic multilevel lumbar degenerative disc disease, with soft tissue injury of the left hip. Dr. Pettingell observed that appellant’s physical examination findings were not consistent with lumbosacral radiculopathy as her deficits were not limited to a myotomal/dermatomal pattern. He also found greater active lumbar range of motion than would be anticipated from the imaging studies. Dr. Pettingell opined that the diagnosed multilevel lumbar degenerative disease was not attributable to the accepted September 13, 2018 employment injury. In support of his conclusion, he explained that appellant’s back pain predated September 13, 2018 and studies performed five days following the incident clearly demonstrated multilevel lumbar chronic degenerative disc disease. Furthermore, a review of MRI scan studies performed before and after September 13, 2018 demonstrated pathology, but no clear worsening of her condition. Thus, Dr. Pettingell concluded that the accepted September 13, 2018 incident did not cause, aggravate, or accelerate appellant’s lumbar spine pathology.

By decision dated November 28, 2022, OWCP denied appellant’s traumatic injury claim, finding that, while the September 13, 2018 employment incident occurred as alleged, the medical evidence of record was insufficient to establish that her diagnosed lumbar conditions were causally related to the accepted employment incident. It found the weight of the medical opinion evidence rested with Dr. Pettingell’s second opinion.

OWCP received reports dated November 23 and December 21, 2022 from Dr. Wilson.
Dr. Wilson related that a November 21, 2018 MRI scan of appellant’s lumbar spine revealed a diffuse bulge at L3-4 with facet hypertrophy along with mild spinal and mild bilateral neuroforaminal stenosis. At L4-5 there was a diffuse disc bulge with facet hypertrophy and mild spinal and moderate bilateral right neuroforaminal stenosis. At L5 -S1 there was central disc protrusion with facet hypertrophy with mild spinal stenosis. Dr. Wilson reiterated his prior diagnoses of lumbosacral intervertebral disc disorders with L3-4, L4-5, and L5-S1 radiculopathy,

6
Id.

4 lumbosacral radiculopathy, and L4 on L5 spondylolisthesis, as well as appellant’s left hip diagnoses.

On December 14, 2022, appellant, through counsel, requested an oral hearing before a representative of OWCP’s Branch of Hearings and Review. By decision dated February 23, 2023, the hearing representative vacated the November 28, 2022 decision and remanded the case for OWCP to amend the SOAF to provide an accurate mechanism of injury and description of appellant’s work duties. The hearing representative further found that the case should then be referred back to Dr. Pettingell for reevaluation. Dr. Pettingell was to address whether the employment incident caused or aggravated a preexisting lumbar or hip condition.

In a May 24, 2023 report, Dr. Michael Thambuswamy, a Board-certified neurosurgeon, recounted appellant’s history of injury, reviewed diagnostic tests and medical records, and provided appellant’s physical examination findings. He stated that appellant was evaluated for lumbar and left hip injuries from a work-related accident/fall on September 13, 2018. On physical examination, Dr. Thambuswamy reported mildly diminished range of motion, mild tenderness on palpation over the bilateral paraspinous muscles, small trigger points palpable on the left L5, decreased L4 and L5 dermatomal sensory loss greater in the left lower extremity, and less than 2+ equal reflexes. He diagnosed L3-4 and L4-5 intervertebral disc disorders with radiculopathy, L5- S1 intervertebral disc disorders with radiculopathy, lumbosacral radiculopathy, L4 -5 spondylolisthesis, left hip bursitis, left hip chondromalacia, and left hip other specified muscle, fascia, and tendon injury.

In a report dated August 18, 2023, Dr. Wilson provided examination findings and reiterated his prior diagnoses, which he attributed to her accepted September 13, 2018 employment incident.

Dr. Wilson, in reports dated September 13 and October 17, 2023, and February 16, 2024, recounted appellant’s history of injury and medical treatment including referral for a lumbar MRI scan. On physical examination, he reported diminished range of motion, some ongoing weakness against resistance, tenderness on palpation over the paraspinous muscles, tenderness on over the left sacroiliac joint, 2+ equal reflexes, and radicular complaints into the L4 and L5 dermatomal distributions, with positive straight leg raising. Dr. Wilson diagnosed left hip chondromalacia, bursitis, and specified injury of the muscle, fascial and tendon. He also diagnosed lumbar L4-5 spondylolisthesis, lumbosacral radiculopathy, and L3-4, L4-5, and L5-S1 intervertebral disc disorders with radiculopathy.

On April 11, 2024, OWCP referred appellant, together with an amended SOAF, position description, medical record, and a series of questions, to Dr. Pettingell for a supplemental opinion.

In reports received April 17 and May 21, 2024, Dr. Wilson repeated his diagnoses and findings.

In a supplemental report dated June 3, 2024, Dr. Pettingell recounted a history of the employment injury and reviewed medical records from 2014 onwards. He noted that appellant related that she had a 2005 employment-related lumbar spine injury and had suffered from low back pain since 2006. On physical examination, Dr. Pettingell reported tenderness on midline lumbar spine palpitation, mid and lower lumbar paraspinal muscles, and bilateral “PSIS region”

5 and greater trochanter, and diminished light touch sensory left lower extremity. He diagnosed mild left hip osteoarthritis and symptomatic multi-level lumbar degenerative disc disease, which he opined was unrelated to the accepted September 13, 2018 employment incident. In support of this conclusion, Dr. Pettingell noted appellant had a history of multiple falls and injuries. He found no direct or indirect employment injury involving the left hip, and no evidence of aggravation of a preexisting condition. Dr. Pettingell further opined there was no objective evidence that the accepted September 13, 2018 employment incident caused or aggravated an underlying preexisting lumbar condition. He explained that lumbar spine x-rays taken in 2014 demonstrated pathology at L5-S1, while the MRI scan studies of 2018 conflict regarding the pathology at L5- S1, and Dr. Wilson’s interpretation of the 2018 x-rays was not supported by the radiologist’s interpretation of the L5-S1 MRI scan pathology. Dr. Pettingell explained that he could not state that the work injury of September 2018 aggravated a preexisting condition, as appellant had a history of back pain going back to 2006. He also explained that while appellant had a history of referred pain to the buttock and lower extremity; to diagnose lumbar radiculopathy the physical examination should demonstrate reproducible deficits of a dermatome/myotome. However, appellant did not have the demonstrated deficits on examination. Dr. Pettingell concluded that he could not state that a single event in September 2018 objectively aggravated/worsened a preexisting lumbar condition or caused a new injury to the lumbar spine.

By de novo decision dated August 14, 2024, OWCP denied appellant’s traumatic injury claim, finding that while the September 13, 2018 employment incident occurred as alleged, the medical evidence of record was insufficient to establish that her diagnosed conditions were causally related to the accepted employment incident.

On August 20, 2024 appellant, through counsel, requested an oral hearing before a representative of OWCP’s Branch of Hearings and Review. A hearing was held on October 22, 2024.

OWCP continued to receive reports dated June 25, July 24, October 2 and 30, and December 3, 2024, wherein Dr. Wilson reiterated his opinion that the accepted September 13, 2018 incident caused appellant’s lumbar spine and left hip conditions.

By decision dated January 3, 2025, OWCP’s hearing representative affirmed the August 14, 2024 decision denying appellant’s traumatic injury claim.

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the essential elements of his or her claim, including the fact that the individual is an employee of the United States within the meaning of FECA, 7 that the claim was timely filed within the applicable time limitation period of FECA, that an injury was sustained in the performance of duty, as alleged, and that any disability or medical condition for which compensation is claimed is causally related

7
K.R., Docket No. 20-0995 (issued January 29, 2021); A.W., Docket No. 19-0327 (issued July 19, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

6 to the employment injury. 8 These are the essential elements of each and every compensation claim, regardless of whether the claim is predicated upon a traumatic injury or an occupational disease. 9

To determine whether a federal employee has sustained a traumatic injury in the performance of duty, it first must be determined whether fact of injury has been established. There are two components involved in establishing fact of injury. The first comp onent is that the employee must submit sufficient evidence to establish that he or she actually experienced the employment incident at the time and place, and in the manner alleged. The second component is whether the employment incident caused a personal injury.10

The medical evidence required to establish causal relationship between a claimed specific condition and an employment incident is rationalized medical opinion evidence. 11 The opinion of the physician must be based on a complete factual and medical background of the employee, must be one of reasonable medical certainty, and must be supported by medical rationale explaining the nature of the relationship between the diagnosed condition and specific employment factors identified by the employee. 12

In any case where a preexisting condition involving the same part of the body is present and the issue of causal relationship, therefore, involves aggravation, acceleration, or precipitation, the physician must provide a rationalized medical opinion that differentiates between the effects of the work-related injury or disease and the preexisting condition. 13

ANALYSIS

The Board finds appellant has not met her burden of proof to establish a medical condition causally related to the accepted September 13, 2018 employment incident.

Initially, the Board notes that it is unnecessary to consider the evidence appellant submitted prior to the issuance of OWCP’s January 24, 2020 decision, which was considered by the Board

8
L.L., Docket No. 21-0991 (issued February 9, 2022); J.M., Docket No. 17-0284 (issued February 7, 2018);
R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 312 (1988). 9 J.B., Docket No. 20-1566 (issued August 31, 2021); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990). 10 L.L., supra note 8; T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. Carlone, 41 ECAB 354 (1989).
11
S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019);
Robert G. Morris, 48 ECAB 238 (1996).
12
T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020);
Victor J. Woodhams, 41 ECAB 345, 352 (1989).
13
Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (May 2023). See O.R., Docket No. 24-0184 (issued February 27, 2024); J.T., Docket No. 22-1308 (issued May 25, 2023); R.D., Docket No. 18-1551 (issued March 1, 2019); Clinton E. Anthony, Jr., 49 ECAB 476, 479 (1998).

7 in its November 23, 2020 decision. Findings made in prior Board decisions are res judicata absent further merit review by OWCP under section 8128 of FECA. 14

OWCP referred appellant to Dr. Pettingell for a second opinion evaluation regarding her traumatic injury claim. In an October 17, 2022 report, Dr. Pettingell reviewed her history of injury, including the SOAF and medical treatment history. He provided examination findings and diagnosed symptomatic multilevel lumbar degenerative disc disease. Dr. Pettingell determined that appellant’s multilevel lumbar degenerative disease was not caused or aggravated, or accelerated by the accepted September 13, 2018 employment incident. In support of his opinion, he explained that her back pain and diagnostic studies clearly demonstrated preexisting multilevel chronic degenerative disc disease. He referenced MRI scans performed before and after September 13, 2018 showed pathology, but no clear worsening. In a June 3, 2024 supplemental report, Dr. Pettingell reviewed medical records from 2014, noting that appellant had a 2005 employment-related lumbar spine injury and has had back pain since 2006. He opined that there was no evidence, indirect or direct, of an employment-related injury involving the left hip. Dr. Pettingell further found no objective evidence that the underlying preexisting lumbar condition had been caused or aggravated by the accepted September 13, 2018 employment incident. He explained that lumbar spine x-rays taken in 2014 demonstrated pathology at L5-S1, while Dr. Wilson’s interpretation of the 2018 diagnostic studies was not supported by the radiologist’s interpretation of the L5-S1 MRI scan pathology. Dr. Pettingell also explained that while appellant had a history of referred pain to the buttock and lower extremity; to diagnose lumbar radiculopathy the physical examination should demonstrate reproducible deficits of a dermatome/myotome. However, appellant did not have the demonstrated deficits on examination.

The Board has reviewed the opinion of Dr. Pettingell and notes that he provided a thorough factual and medical history and accurately summarized the relevant medical evidence. 15 Dr. Pettingell’s reports constitute the weight of the medical evidence.

Following the January 4, 2022 decision, OWCP received additional evidence from Dr. Wilson. In reports dated August 17, 2022 through December 3, 2024, Dr. Wilson recounted a history of lumbar and left hip conditions following an September 13, 2018 fall. He opined that the diagnosed conditions were attributable to the accepted September 13, 2018 incident. However, Dr. Wilson did not explain with rationale how or why the September 13, 2018 employment incident would have caused or aggravated the diagnosed conditions. His opinion is therefore of limited probative value and insufficient to establish the claim.16

On May 24, 2023, Dr. Thambuswamy evaluated appellant and noted diagnoses of L3-4 and L4-5 intervertebral disc disorders with radiculopathy, L5-S1 intervertebral disc disorders with radiculopathy, lumbosacral radiculopathy, L4-5 spondylolisthesis, left hip bursitis, left hip chondromalacia, and left hip other specified muscle, fascia, and tendon injury. He did not,

14
L.L., supra note 8; A.A., Docket No. 20-1399 (issued March 10, 2021); Clinton E. Anthony, Jr., id.

G.V., Docket No. 22-1257 (issued March 14, 2024); V.B., Docket No. 22-0799 (issued October 25, 2022); J.W., 15

Docket No. 18-0670 (issued September 11, 2018).
16
T.S., Docket No. 23-0772 (issued March 28, 2024); D.F., Docket No. 19-0067 (issued May 3, 2019).

8 however, provide an opinion on causal relationship. The Board has held that medical evidence that does not provide an opinion regarding causal relationship is of no probative value and, thus, is insufficient to establish a claim.17

As the medical evidence of record is insufficient to establish causal relationship between the diagnosed lumbar and left hip conditions and the September 13, 2018 employment incident, the Board finds that appellant has not met her burden of proof.

Appellant may submit new evidence or argument with a written request for reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.

CONCLUSION

The Board finds appellant has not met her burden of proof to establish a medical condition causally related to the accepted September 13, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 3, 2025 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: March 3, 2025
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge Employees’ Compensation Appeals Board

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

17
G.V., supra note 15; L.B., Docket No. 22-0339 (issued June 21, 2023); D.K., Docket No. 17-1549 (issued July 6, 2018).

9